Nursing assessment of the ambulatory patient with brain metastases

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Abstract
Brain metastases occur in 12–24% of all persons with cancer and this incidence is expected to increase in the future. The oncology nurse working in the ambulatory and home care settings has a key role assisting persons with brain metastases and their families to live with the numerous problems assoclated with this diagnosis. The purpose of this paper is to present a framework for the nursing assessment of ambulatory patients with brain metastases. Incidence, prognosis, mechanism of spread, pathophysiology, and clinical manifestations of brain metastases are discussed as background for the assessment. The assessment framework was developed by the author to improve and organize care to persons with brain metastases. It has been useful in clinical practice. The assessment includes an initial baseline evaluation which Incorporates a general nursing history and a neurologlcally focused physical examination. Flow sheets are used to monitor selected parameters on an ongoing basis.

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